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Organization
GENESIS MEDICAL ASSOCIATES, INC.
Active
Organization
GENESIS MEDICAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD STEVENSON (CFO)
(412) 369-9550
Entity
Organization
Contact information
Practice address
188 ENCLAVE DR, NEW CASTLE, PA 16105-3208
(724) 657-3201
(724) 657-3223
Mailing address
8150 PERRY HWY STE 201, PITTSBURGH, PA 15237-5200
(412) 369-9550
(412) 369-9566
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001517153-0050
—
PA
01
—
5364924
BLUE SHIELD
PA
Enumeration date
08/30/2023
Last updated
01/19/2024
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